Rehabilitation following Hindfoot Surgery

This is to provide a general guide on what you would expect following surgery on the hindfoot. This includes are procedures that reconstruct the hindfoot through fusion, osteotomy or tendon transfers. This is a general guide and individual operations or patients may need to follow a different program. Please read this in conjunction with the information on this site relating to your particular treatment.

Immediately post op on day 1

Hindfoot surgery is usually performed under general aneasthetic but you would have also been given a nerve block aneasthetic so when you wake up your ankle should be comfortable and pain free. Occasionally the block may not be fully effective and in those cases additional pain medication may be needed.  You are also likely to have been put in a plaster backslab, this is a half plaster half bandage type splint that is used following surgery.

if the plan is for you to be discharged from hospital on the same day then you are likely to have to practice walking around on crutches. The physiotherapists will help you with this to make sure you are able to use them safely. Those who are non weight bearing will also be given blood thinning injections and a nurse will teach you how to administer them yourself on a daily basis.

Weeks 0-2

In this time, you will be in the post-operative plaster backslab. You must not bear weight on the operated leg. Take time to elevate and control the swelling and take the prescribed painkillers once the local aneasthetic block has worn off (usually by around 24 hours post op).

You should also try and get around on crutches regularly to make sure the rest of your bones and joints don’t become weak and wasted. It will also help blood flowing around and reduces the risk of thrombosis.

At the end of this period you will have an appointment to see me. We will then change the cast to a full plaster and inspects the wounds.

Weeks 2-6

Following your 2 week appointment you will remain non-weightbearing on your crutches for a further 4 weeks. You would have been placed in another lighter weight cast or sometimes a walker boot may be used instead of a cast.

You must continue with regular elevation and control the swelling. Using Ice if possible. The pain should be more tolerable by now and you may need fewer painkillers.

Weeks 6-12

You will attend for a check X-ray at the 6 week mark and at this stage if good healing is seen you will be taken out of the cast. Occasionally you may be taken out completely into your normal footwear but often a walking boot is provided to help you transition.

Weeks 12 plus

At this stage an X-ray is repeated and full healing should be demonstrated. You will be in your normal footwear and getting back to normal day to day activity perhaps with a physiotherapist helping you. Return to higher impact activities is normally possible from around 6 months post op.

Further useful information can be obtained from Guy’s hospital information leaflet on Ankle and hindfoot fusions found here.